Use of T1 mapping in cardiovascular MRI in follow up of a pediatric fabry cohort

IF 18 Q4 Medicine
O. Werner, M. Fila, L. Ichay, M. Vincenti
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引用次数: 0

Abstract

Introduction

Fabry disease (FD) is a rare X-linked lysosomal storage disorder caused by a mutation on the alpha-galactosidase-A gene. The prognosis lies in the severity of the cardiac involvement which is the leading cause of mortality. Usually, it presents with hypertrophic cardiomyopathy, valvular disease, or conduction abnormalities. This process of storage is also present in every other organ and begins before birth. Enzyme replacement therapy (ERT) has shown a spectacular effect on extra-cardiac symptoms especially if started early in life. The effect of ERT on cardiac lesions is still a research question. Cardiac magnetic resonance (CMR) is a key exam in FD with its capacity of tissular characterization. But to date, there is a lack of data in the pediatric population to understand how to integrate CMR in early therapeutic decisions.

Methods

Monocentric cross-sectional study carried out in Montpellier University hospital from 2016 to 2022. All pediatric patients with FD were evaluated over time with clinical, biological and cardiac imaging (CMR, TEE). The objective was to determine the place of CMR in the therapeutic decisions.

Results/Expected results

In total, 6 patients were included, 3 boys/3 girls. Five patients were treated with ERT during the study. Low T1 values were observed in 4 patients. The normalization of T1 values was observed in the 4 years after ERT introduction for 3 patients (Figure 1).

Conclusion/Perspectives

CMR has to take an important role in the evaluation of FD. In the pediatric population, a recurrent assessment can be useful to detect the pejorative evolution of T1, especially in partial forms of Fabry disease. Obvious need of strong data is required to help the clinician in his daily practice.

T1标测在儿科fabry队列心血管MRI随访中的应用
法布里病(FD)是一种罕见的x连锁溶酶体储存疾病,由α -半乳糖苷酶a基因突变引起。预后取决于心脏受累的严重程度,这是导致死亡的主要原因。通常表现为肥厚性心肌病、瓣膜疾病或传导异常。这种储存过程也存在于其他器官中,并且在出生前就开始了。酶替代疗法(ERT)已经显示出对心脏外症状的惊人效果,特别是如果在生命早期开始。ERT对心脏病变的影响仍是一个研究问题。心脏磁共振(CMR)是FD的一项关键检查,具有组织表征的能力。但到目前为止,在儿科人群中缺乏数据来了解如何将CMR整合到早期治疗决策中。方法2016 - 2022年在蒙彼利埃大学医院进行单中心横断面研究。对所有FD患儿进行临床、生物学和心脏影像学(CMR, TEE)评估。目的是确定CMR在治疗决策中的地位。结果/预期结果共纳入6例患者,男3例,女3例。5例患者在研究期间接受ERT治疗。4例患者T1值较低。在3例患者引入ERT后的4年中,观察到T1值的正常化(图1)。结论/观点cmr在FD的评估中必须发挥重要作用。在儿科人群中,复发性评估可用于检测T1的恶性演变,特别是部分形式的法布里病。显然,临床医生在日常实践中需要强有力的数据来帮助。
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来源期刊
Archives of Cardiovascular Diseases Supplements
Archives of Cardiovascular Diseases Supplements CARDIAC & CARDIOVASCULAR SYSTEMS-
自引率
0.00%
发文量
508
期刊介绍: Archives of Cardiovascular Diseases Supplements is the official journal of the French Society of Cardiology. The journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles, editorials, and Images in cardiovascular medicine. The topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Additionally, Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.
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